Definition of Grades for Recommendation and Suggestion for Practice

Grade	Definition	Suggestion for Practice
A	This intervention is recommended. There is a high certainty that the net benefit is substantial	Offer and administer this intervention
B	This intervention is recommended. There is a moderate certainty that the net benefit is moderate to substantial	Offer and administer this intervention
C	This intervention is recommended. There may be considerations that support the use of this intervention in an individual patient. There is a moderate to high certainty that the net benefit is small	Offer and administer this intervention only if other considerations support this intervention in an individual patient
D	This intervention is not recommended. There is a moderate to high certainty that the intervention has no net benefit and that the harms outweigh the benefits	Discourage use of this intervention
I	The current evidence is insufficient to assess the balance of benefits against and harms of this intervention. There is a moderate to high certainty that the intervention has no net benefit and that the harms outweigh the benefits. Evidence is lacking, of poor quality, or conflicting, and the balance of benefits and harms cannot be determined	If this intervention is conducted, the patient should understand the uncertainty about the balance of benefits and harms